Blogkoopedia: The Vulnerability of Kidneys to Unhealthy Lifestyle Habits

The Vulnerability of Kidneys to Unhealthy Lifestyle Habits

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logkoopedia: The Vulnerability of Kidneys to Unhealthy Lifestyle Habits - The kidneys, two bean-shaped organs located in the back of the abdominal cavity, are indispensable for maintaining the body's internal balance. Responsible for filtering waste products and toxins from the bloodstream, they play a pivotal role in maintaining optimal health. However, the kidneys are vulnerable to damage, particularly when subjected to an unhealthy lifestyle. Despite the wealth of knowledge about the consequences, a distressing number of people persist in habits that place undue strain on these vital organs, elevating the risk of severe health issues and potentially triggering dangerous diseases.

The Vulnerability of Kidneys to Unhealthy Lifestyle Habits is a pressing concern that demands attention. The kidneys, being crucial organs responsible for filtering waste and toxins from the bloodstream, are at risk when subjected to unhealthy lifestyle habits. Acknowledging The Vulnerability of Kidneys to Unhealthy Lifestyle Habits is essential in raising awareness about the potential risks involved. Despite the wealth of knowledge available, many individuals persist in habits that impose undue strain on these vital organs, elevating the risk of severe health issues and dangerous diseases.

To address The Vulnerability of Kidneys to Unhealthy Lifestyle Habits, it is vital to recognize the various unhealthy behaviors that pose a threat to kidney health. Excessive salt consumption, neglecting regular blood pressure checks, smoking, inadequate hydration, careless use of medications, lack of sleep, and excessive alcohol consumption are all contributing factors. By understanding The Vulnerability of Kidneys to Unhealthy Lifestyle Habits, individuals can take proactive measures to protect their kidney health. Adopting a balanced diet, maintaining a healthy weight, exercising regularly, abstaining from harmful habits, staying well-hydrated, and getting sufficient rest are crucial steps in supporting kidney health and promoting overall well-being.

1. Consuming Foods High in Salt

The modern diet is often characterized by an overabundance of sodium, commonly found in processed and fast foods. While a pinch of salt enhances flavors, excessive consumption of sodium can lead to an imbalance in the body's fluid levels, elevating blood pressure and placing a strain on the kidneys.

Foods high in salt are not limited to homemade meals; packaged snacks like chips, biscuits, and other processed goodies often harbor substantial amounts of sodium. Regrettably, many individuals remain unaware of this hidden salt content, as the salty taste may not always be immediately apparent. Consequently, the kidneys bear the brunt of this excess sodium, and prolonged exposure can lead to decreased kidney function.

Renowned health expert James Simon, affiliated with the prestigious Cleveland Clinic, warns that a penchant for high-sodium foods can significantly elevate the risk of developing kidney stones, a painful and potentially dangerous condition.

To safeguard kidney health, health experts strongly advise limiting daily sodium intake to a maximum of 2,300 milligrams, as outlined by dietary guidelines. By adopting a conscious approach to salt consumption and opting for natural flavors through herbs and spices, individuals can effectively support their kidney function and overall well-being.

2. Neglecting Regular Blood Pressure Checks

Blood pressure, the force exerted by the blood against the walls of the arteries, plays a pivotal role in kidney health. Uncontrolled high blood pressure, also known as hypertension, places immense strain on the blood vessels throughout the body, including those within the kidneys. This can lead to a condition called renal hypertension, wherein the blood vessels in the kidneys narrow, impeding proper blood flow and compromising their function.

Alarmingly, many individuals remain oblivious to their blood pressure levels due to infrequent or non-existent check-ups. This lack of awareness poses a significant risk, as uncontrolled hypertension can slowly and silently damage the kidneys, leading to chronic kidney disease (CKD) over time.

Routine blood pressure checks, at least twice a year, are essential in monitoring this vital health indicator. Early detection of high blood pressure can prompt lifestyle modifications, such as adopting a balanced diet, exercising regularly, and managing stress, all of which contribute to maintaining healthy blood pressure levels and preserving kidney function.

3. The Perils of Smoking

The harmful effects of smoking are widely known and encompass almost every organ and system in the human body. Smoking leads to vasoconstriction, a narrowing of blood vessels, and a surge in blood pressure, burdening the kidneys and affecting their ability to function optimally.

The chemicals in tobacco smoke, including nicotine and carbon monoxide, wreak havoc on the cardiovascular system, reducing blood flow to vital organs like the kidneys. This reduction in blood flow can lead to impaired kidney function and an increased risk of kidney disease.

Studies have demonstrated that individuals who smoke for an extended period, approximately 16 years or more, face a staggering 40% increase in the risk of developing kidney cancer. This sobering statistic underscores the grave consequences of smoking on kidney health.

Smoking cessation is vital not only for the kidneys but also for overall well-being. Quitting smoking is a challenging but crucial step towards better kidney health and a longer, healthier life.

4. Inadequate Hydration: A Hidden Threat

Water is essential for life, and the body's various systems depend on proper hydration to function optimally. The kidneys play a central role in maintaining water balance, as they are responsible for filtering the blood and excreting waste products and excess fluids through urine.

Insufficient water intake can lead to dehydration, which not only causes discomfort but also poses a serious threat to kidney health. When the body lacks adequate fluids, the kidneys are forced to work harder to concentrate urine and retain essential nutrients. Over time, this can lead to a buildup of waste products and toxins in the kidneys, impairing their ability to function and potentially causing kidney stones and other complications.

Adequate hydration is key to supporting kidney health. Experts recommend drinking at least eight cups (64 ounces) of water per day, but individual needs may vary depending on factors such as climate, physical activity, and overall health. It is essential to listen to the body's signals and ensure that it receives the hydration it requires to maintain kidney health and overall well-being.

5. Careless Use of Medications

Medications, when used responsibly and as prescribed by healthcare professionals, can be powerful tools in managing various health conditions. However, careless use of medications, especially painkillers and nonsteroidal anti-inflammatory drugs (NSAIDs), can lead to serious kidney damage.

These medications, while effective in relieving pain and inflammation, can affect blood flow to the kidneys and impair their filtering function. Prolonged or excessive use of NSAIDs can cause a condition known as analgesic nephropathy, characterized by kidney damage and impaired function.

Additionally, certain medications, when taken inappropriately or without medical supervision, can lead to drug-induced kidney toxicity. It is crucial to follow the recommended dosage and duration of use for any medication, and individuals should always consult their healthcare providers before starting or stopping any drug regimen.

6. Sleep Deprivation and Kidney Health

The importance of sufficient sleep in promoting overall health and well-being cannot be overstated. During sleep, the body undergoes essential processes, including repair and regeneration, that are vital for organ function and overall vitality.

Lack of sleep not only affects energy levels and cognitive function but can also impact kidney health. When the body is deprived of restful sleep, stress hormones are released, leading to increased blood pressure and vascular constriction. These changes can impair blood flow to the kidneys, hindering their ability to function optimally.

Consistently getting an adequate amount of quality sleep is crucial for supporting kidney health and overall wellness. Most adults require seven to nine hours of sleep each night to maintain their physical and mental well-being.

7. Excessive Alcohol Consumption: A Threat to Kidney Health

While moderate alcohol consumption may have some health benefits, excessive and chronic alcohol intake can lead to severe health issues, including liver disease and kidney damage.

The kidneys play a role in metabolizing alcohol and its by-products, and prolonged exposure to high levels of alcohol can damage the kidneys' delicate structures. Chronic alcohol abuse can lead to a condition known as alcoholic nephropathy, characterized by progressive kidney damage and impaired function.

Additionally, excessive alcohol consumption can lead to dehydration, which poses a double threat to kidney health. Not only does dehydration strain the kidneys, but it can also lead to an increased risk of kidney stones.

Responsible alcohol consumption is essential for safeguarding kidney health. For most individuals, this means limiting alcohol intake to moderate levels, as defined by health authorities, and ensuring adequate hydration when consuming alcoholic beverages.

Frequently Asked Questions (FAQs)

What are the kidneys' functions, and why are they crucial for optimal health?

• The kidneys are responsible for filtering waste products and toxins from the bloodstream, regulating water and mineral levels, and excreting waste and excess fluids through urine. They play a pivotal role in maintaining the body's internal balance, contributing to overall health and well-being.

How does an unhealthy lifestyle affect kidney health?

• An unhealthy lifestyle, characterized by habits like excessive salt consumption, neglecting blood pressure checks, smoking, inadequate hydration, careless medication use, lack of sleep, and excessive alcohol consumption, can significantly compromise kidney function and elevate the risk of severe health issues.

Can excessive salt consumption harm the kidneys?

• Yes, consuming foods high in salt can lead to an imbalance in the body's fluid levels, elevating blood pressure and placing a strain on the kidneys. Prolonged exposure to excess sodium may lead to decreased kidney function and an increased risk of developing kidney stones.

Why are regular blood pressure checks important for kidney health?

• Uncontrolled high blood pressure can damage the blood vessels within the kidneys, leading to renal hypertension. Regular blood pressure checks help monitor this vital health indicator and enable early detection and management of hypertension, which can preserve kidney function and prevent chronic kidney disease.

How does smoking affect kidney health?

• Smoking causes vasoconstriction, narrowing blood vessels and increasing blood pressure, which can burden the kidneys and impair their optimal functioning. Chronic smoking is associated with an elevated risk of kidney cancer and can lead to kidney disease.

Can inadequate hydration harm the kidneys?

• Yes, insufficient water intake can lead to dehydration, forcing the kidneys to work harder to concentrate urine and retain essential nutrients. Over time, this may result in a buildup of waste products and toxins, potentially causing kidney stones and other complications.

How does careless use of medications impact kidney health?

• Careless use of medications, especially painkillers and nonsteroidal anti-inflammatory drugs (NSAIDs), can damage the kidneys by affecting blood flow and filtering function. It is crucial to follow prescribed dosages and consult healthcare providers to prevent drug-induced kidney toxicity.

How does sleep deprivation affect kidney health?

• Lack of sufficient sleep can lead to stress hormone release, raising blood pressure and impacting blood flow to the kidneys. Consistently getting adequate quality sleep is essential for supporting kidney health and overall wellness.

What are the risks of excessive alcohol consumption on the kidneys?

• Chronic alcohol abuse can damage the kidneys' delicate structures, leading to a condition known as alcoholic nephropathy, characterized by progressive kidney damage and impaired function. Additionally, excessive alcohol consumption can lead to dehydration, posing further threats to kidney health.

What proactive measures can individuals take to protect kidney health?

• To safeguard kidney health, individuals can adopt a balanced diet, maintain a healthy weight, exercise regularly, quit smoking, limit alcohol consumption to moderate levels, stay well-hydrated, and prioritize sufficient sleep. These lifestyle choices can contribute to supporting kidney function and promoting overall well-being.

Conclusion

The kidneys are marvels of nature, responsible for essential bodily functions that maintain internal balance and overall health. However, they are not impervious to the effects of an unhealthy lifestyle. Consuming excessive salt, neglecting blood pressure checks, smoking, inadequate hydration, careless use of medications, lack of sleep, and excessive alcohol consumption can all significantly impact kidney health, leading to severe consequences for overall well-being.

By understanding the risks associated with these habits, individuals can make informed choices to safeguard their kidney health and overall quality of life. Proactive measures, such as adopting a balanced diet, maintaining a healthy weight, exercising regularly, abstaining from smoking and excessive alcohol consumption, and staying well-hydrated, can all contribute to supporting kidney health and promoting longevity.

Remember, the kidneys are irreplaceable organs that deserve our utmost care and attention. Empower yourself with knowledge and make choices that prioritize the well-being of these vital filters. By doing so, you can enjoy a life of vibrant health and vitality, with your kidneys functioning at their best to support your every endeavor.

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The Association Between Unhealthy Lifestyle Behaviors and the Prevalence of Chronic Kidney Disease (CKD) in Middle-Aged and Older Men

Background

This cross-sectional study evaluated the association between unhealthy lifestyle behaviors and the prevalence of chronic kidney disease (CKD) in middle-aged and older men.

Methods

The subjects included 445 men without a history of cardiovascular disease, stroke, or dialysis treatment, who were not taking medications. Unhealthy lifestyle behaviors were evaluated using a standardized self-administered questionnaire and were defined as follows: 1) lack of habitual moderate exercise, 2) lack of daily physical activity, 3) slow walking speed, 4) fast eating speed, 5) late-night dinner, 6) bedtime snacking, and 7) skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions based on the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors).

Results

According to a multivariate analysis, the odds ratio (OR) for CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or proteinuria) was found to be significantly higher in the ≥4 group than in the 0–1 group (OR 4.67; 95% confidence interval [CI], 1.51–14.40). Moreover, subjects’ lack of habitual moderate exercise (OR 3.06; 95% CI, 1.13–8.32) and presence of late-night dinner (OR 2.84; 95% CI, 1.40–5.75) and bedtime snacking behaviors (OR 2.87; 95% CI, 1.27–6.45) were found to be significantly associated with the prevalence of CKD.

Conclusions

These results suggest that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

Key words: prevalence of CKD, unhealthy lifestyle behaviors, habitual moderate exercise, late-night dinner, bedtime snacking

INTRODUCTION

The number of patients with end-stage renal disease (ESRD) in Japan is continuously increasing. Chronic kidney disease (CKD) has been associated with the development of ESRD and cardiovascular disease (CVD).1,2 Currently, the large number of ESRD patients is thought to relate to the increasing number of patients with CKD. Many of the risk factors for CKD are reported to be caused by the aging, hypertension, diabetes mellitus, and metabolic syndrome.3–5

In addition to hypertension, diabetes mellitus, and metabolic syndrome, the incidence of CKD is also closely correlated with unhealthy lifestyle behaviors, such as smoking, heavy alcohol intake, obesity, physical inactivity, and unhealthy diet.6–11 We previously performed a cross-sectional study, which demonstrated that the aerobic capacity and physical activity levels in patients with CKD were significantly lower than in patients without CKD.12 Thus, lifestyle modifications in the early stages of hypertension, diabetes mellitus, dyslipidemia, and metabolic syndrome are considered necessary to prevent the development of CKD. However, at present, the accumulation of unhealthy lifestyle behaviors on the risk of CKD has not been studied.

The accumulation of unhealthy lifestyle behaviors has been shown to be associated with the incidence of CVD, stroke, metabolic syndrome, type 2 diabetes, hypertension, and dyslipidemia.13–17 Clarification of the influence of the accumulation of unhealthy lifestyle behaviors on the prevalence of CKD may help to demonstrate the importance of lifestyle modifications in CKD prevention. We considered that unhealthy lifestyle behaviors might be shown to predict the incidence of CKD because an accumulation of unhealthy lifestyle behaviors has been shown to be associated with the development of CVD, stroke, and several coronary risk factors.13–17 We focused on the physical activity, exercise, and eating habits as lifestyle behaviors because increases in the daily physical activity and changes in diet are a very important initial step for the prevention of CVD.18 This cross-sectional study was designed to evaluate the association between unhealthy lifestyle behaviors and the prevalence of CKD in middle-aged and older men.

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METHODS

Subjects

A total of 574 middle-aged and older men received their periodic health check at a health care center in Fukuoka University from 2008 to 2013. Subjects with a past history of CVD (n = 9), stroke (n = 1), and/or dialysis treatment (n = 1), or those taking medications (n = 115), such as anti-hypertensive drugs, statins or hypoglycemic agents, were excluded from the analysis because we focused on the effects of lifestyle behaviors without the influence of these medications; women were excluded to remove the influence of gender. A total of 445 men (mean [standard deviation {SD}] age, 50.9 [8.0] years; mean [SD] body mass index [BMI], 23.1 [2.6] kg/m2; mean [SD] serum creatinine, 0.87 [0.13] mg/dL; and mean [SD] glomerular filtration rate [GFR], estimated using the Japanese GFR inference formula [eGFR], 75.6 [12.1] mL/min/1.73 m2),19 with no missing information, were eligible for the present study.

All subjects gave informed consent for participation after agreeing with the purpose, methods, and significance of the study. This study conformed to the Declaration of Helsinki, and was approved by the Ethics Committee of Fukuoka University (No. 11-08-01).

Blood sampling, blood pressure, and anthropometric measurements

Blood samples were collected early in the morning via venipuncture from an antecubital vein after at least 12 hours of fasting. The blood samples were analyzed by Special Reference Laboratories (SRL Inc., Tokyo, Japan). The serum creatinine, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured using the direct method. The triglyceride levels were measured using the enzyme method. The plasma glucose was measured using an ultraviolet/hexokinase method, and hemoglobin A1c (HbA1c) was measured using high-performance liquid chromatography. HbA1c is presented as the National Glycohemoglobin Standardization Program (NGSP) value, which was calculated using the conversion equation for HbA1c derived by the Japan Diabetes Society (JDS): HbA1c (NGSP value; %) = 1.02 × JDS value (%) + 0.25%.20

The eGFR was calculated using the Japanese GFR inference formula: eGFR (mL/min/1.73 m2) = 194 × serum creatinine (mg/dL)−1.094 × age (years)−0.287.21 The GFR is an accurate measure of renal function22 and identifies patients with mild renal impairment despite normal or nearly normal creatinine levels. Moreover, the eGFR is a strong predictor of cardiovascular events and is more useful for this purpose than serum creatinine.23,24 Urinalysis to detect proteinuria was performed using a dipstick, and the urine test results were classified as (−), (±), (1+), (2+), and (3+).25 In this study, the CKD was defined according to the definition of the Japanese Society of Nephrology (eGFR <60 mL/min/1.73 m2, proteinuria positive [1+ or greater], or both).19

Blood pressure was measured in the right arm with the subject sitting in a chair, after more than 5 minutes of rest, and was expressed as an average of duplicate measurements. Height and body weight were measured, and BMI was calculated as the ratio of body weight (kg) to height squared (m2). Waist circumference was measured at the level of the umbilicus.

Assessment of lifestyle behaviors

The subjects’ drinking and smoking habits and lifestyle behaviors regarding exercise, physical activity, and diet were selected for the present study based on the standardized self-administered questionnaire of the National Health Promotion Program, which was started in Japan in fiscal year 2008, and which aimed at preventing CVD, stroke, and metabolic syndrome.26,27 Previous studies have noted that the combination of these lifestyle behaviors is related to mortality and incidence/prevalence of CVD, metabolic syndrome, type 2 diabetes, hypertension, and dyslipidemia.15–17 The subjects’ drinking and smoking habits and lifestyle behaviors were determined based on their responses to the following questionnaire items: 1) habitual moderate exercise ≥30 minutes per session ≥2 times per week (yes or no); 2) physical activity equal to walking at least 1 hour per day (yes or no); 3) walking speed, compared with people of the same sex and age-group (fast or slow); 4) eating speed, compared with others (fast or slow); 5) late-night dinner ≥3 times per week (yes or no); 6) bedtime snacking ≥3 times per week (yes or no); and 7) skipping breakfast ≥3 times per week (yes or no). The subjects drinking and smoking habits were assessed by the following questionnaire items (with “yes” or “no” responses): drinking habit and smoking habit. The total number of unhealthy lifestyle behaviors related to physical activity, exercise, and eating habits (ie, lack of habitual moderate exercise, lack of daily physical activity, slow walking speed, fast eating speed, late-night dinner, bedtime snacking and skipping breakfast) was calculated for each subject.

Statistical analysis

Data were expressed as the means and SDs. The StatView J-5.0 software package (SAS Institute, Cary, NC, USA) was used for all of the statistical analyses. In this study, the subjects’ drinking and smoking habits and lifestyle behaviors regarding exercise, physical activity, and diet were expressed as category variables, and other coronary risk factors, such as biochemical, blood pressure, and anthropometric indices, were expressed as continuous variables. The inter-group comparisons were performed using the Welch’s t-test for continuous variables and the chi-square test for categorical variables. The participants were divided into four categories defined by quartile distributions of the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors). The inter-multiple group relationships were determined using a one-way repeated measures analysis of variance and the Tukey-Kramer method. A multiple logistic regression analysis was performed to determine the associations between the unhealthy lifestyle behaviors and the prevalence of CKD. In this multiple logistic regression analysis, the level of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4) was a dependent variable and the prevalence of CKD was an independent variable; age, BMI, smoking habit, drinking habit, triglyceride and HbA1c levels, and systolic and diastolic blood pressure were entered as adjusted factors, because these factors potentially influence unhealthy lifestyle behaviors and renal function. A probability value <0.05 was considered to be statistically significant.

RESULTS

Table ​Table11 compares the subjects’ characteristics and the coronary risk factors between the CKD and non-CKD groups. The characteristics of the individuals with and without CKD were as follows: 39 subjects were found to have CKD (mean [SD] age, 55.1 [6.8] years; mean [SD] BMI, 23.9 [2.2] kg/m2; mean [SD] serum creatinine, 1.15 [0.15] mg/dL; mean [SD] eGFR, 53.9 [6.2] mL/min/1.73 m2, including 5 subjects with proteinuria), while 406 subjects had normal renal function (mean [SD] age, 50.5 [6.8] years; mean [SD] BMI, 23.1 [2.7] kg/m2; mean [SD] serum creatinine, 0.84 [0.09] mg/dL; mean [SD] eGFR, 77.7 [10.3] mL/min/1.73 m2). Subjects were categorized by grade of CKD18 as follows: 45 participants (10.1%) were G1 (eGFR ≥90 mL/min/1.73 m2); 361 subjects (81.1%) were G2 (eGFR 60–89 mL/min/1.73 m2); 34 subjects (7.6%) were G3a (eGFR 45–59 mL/min/1.73 m2); and 5 subjects (1.1%) were G3b (eGFR 30–44 mL/min/1.73 m2). The serum creatinine level, age, BMI, systolic blood pressure, diastolic blood pressure, and HbA1c level were significantly higher and eGFR was significantly lower in the CKD group than in the non-CKD group (P < 0.05).

DISCUSSION

The major finding of our study was that the number of unhealthy lifestyle behaviors was significantly higher in the CKD group than in the non-CKD group. Furthermore, after adjusting for the age, BMI, smoking habit, drinking habit, triglyceride and HbA1c levels, and systolic and diastolic blood pressure, an increase in the number of unhealthy lifestyle behaviors was found to be associated with an increase in the prevalence of CKD.

It is well known that the accumulation of unhealthy lifestyle behaviors is associated with increased incidence of non-communicable diseases, including metabolic syndrome, type 2 diabetes, hypertension, and dyslipidemia. We can assume that the relationship between unhealthy lifestyle behaviors and CKD has the same mechanisms, and that the accumulation of unhealthy lifestyle behaviors plays a pivotal role in development of these diseases. However, the causality in the relationship of unhealthy lifestyle behaviors with the prevalence of CKD could not be elucidated, due to the cross-sectional design of the present study. In a cross-sectional study using health check-up data, Fujibayashi et al28 investigated the association of unhealthy lifestyle behaviors with proteinuria and eGFR and showed that the incidence of proteinuria and a low eGFR (<60 mL/min/1.73 m2) increased with increasing number of unhealthy lifestyle factors, and that proteinuria and low eGFR were related to obesity, smoking, eating irregular meals, sleeping less than 5 hours a day, and exercising less than once a week. We found that the relative risk for the prevalence of CKD was significantly elevated by an increase in the number of unhealthy lifestyle behaviors. This finding is consistent with the findings of previous studies. Therefore, the results of the present study were considered to support the possibility that the accumulation of unhealthy lifestyle behaviors is an independent risk factor for the development of CKD. Based on these findings, not only individual lifestyle behaviors but also the accumulation of unhealthy lifestyle behaviors may be associated with the incidence of CKD, ESRD, and CVD.

According to our data, unhealthy lifestyle behaviors related to lack of habitual moderate exercise, lack of daily physical activity, late-night dinner, and bedtime snacking were significantly higher in the CKD group than in the non-CKD group, while in a multivariate analysis, which was adjusted for age, BMI, smoking and drinking habits, triglyceride and HbA1c levels, and systolic and diastolic blood pressure, only lack of habitual moderate exercise, late-night dinner, and bedtime snacking were significantly associated with the prevalence of CKD. Notably, there were no significant differences between the CKD and non-CKD groups with regard to the other assessed lifestyle behaviors, such as slow walking speed, fast eating speed, and skipping breakfast. Recently, several studies have demonstrated that individual lifestyle behaviors related to exercise, physical activity, and diet are correlated with the prevalence of CKD. Robinson-Cohen et al29 observed that each 60-minute increment in weekly physical activity was associated with a 0.5% decline in eGFR per year. In addition, a previous meta-analysis showed that a lack of habitual exercise and decreased physical activity influence the development of CKD through obesity, hypertension, and type 2 diabetes.9 Moreover, it has been reported that an unhealthy diet including high levels of dietary animal fat, sodium, and soft drink consumption leads to the development of renal dysfunction.30–32 Kutsuma et al33 showed that, in Japanese adults, the combination of skipping breakfast and late-night dinners had a greater association with the prevalence of metabolic syndrome and proteinuria than skipping breakfast or late-night dinner alone. Based on these findings, the combination of regular habitual exercise and healthy eating habits may be important for preventing the development of CKD.

Previous studies have noted that lack of habitual moderate exercise, late-night dinner, and bedtime snacking were related to mortality and the incidence/prevalence of CVD, metabolic syndrome, type 2 diabetes, hypertension, and dyslipidemia.34–36 The current findings suggest that lack of habitual moderate exercise, late-night dinner, and bedtime snacking may be independent risk factors for the development of CKD, and that they may indirectly influence the development of subsequent ESRD and CVD in middle-aged and older men. Therefore, we consider that the assessment of unhealthy lifestyle behaviors, with a particular focus on regular habitual exercise and healthy eating habits (such as avoiding late-night dinners and bedtime snacking) is necessary when performing lifestyle counseling to prevent the early stages of CKD.

Study limitations and clinical implications

There are several limitations to the present study. First, the limited study population included a small number of male subjects, who were predominantly middle-aged and older, who were not taking any medications, and who did not have any health complications. Thus, our study contains selection bias, because our limited study population may include more CKD subjects with very slowly declining renal function than CKD subjects with fast progression. Therefore, it remains unclear whether our findings are applicable to women, patients with ESRD, or those who have other complications. Second, due to the cross-sectional design of the study, it was not possible to clarify the causality of the relationship between the unhealthy lifestyle behaviors and the prevalence of CKD. Third, while renal function is influenced by dietary electrolytes, the present study could not confirm the dietary total energy or sodium and potassium intake of the subjects. Therefore, we could not clarify the influence of dietary electrolytes using the subjects’ dietary records. Finally, we assessed the eGFR using the Japanese GFR inference formula21 and used proteinuria as an index of renal function. To more fully evaluate the influence of unhealthy lifestyle behaviors on renal function, other indices of renal function, such as urinary protein excretion, microalbuminuria, or cystatin C should be simultaneously assessed. We could not measure these additional markers of renal function because this study was performed within the constraints of the health check-up.

However, this study is the first report to evaluate the association between accumulation of unhealthy lifestyle behaviors and the prevalence of CKD. Serum creatinine level can be easily measured as part of a routine clinical evaluation. However, eGFR is a strong predictor of cardiovascular events and is more useful for this purpose than serum creatinine level.23,24 Furthermore, in several recent studies, it has been clearly demonstrated that the incidence of CKD is also closely correlated with unhealthy lifestyles behaviors, such as smoking, heavy alcohol intake, obesity, physical inactivity, and unhealthy diet.6–11 Therefore, the results of the present study show a link between the accumulation of unhealthy lifestyle behaviors and the prevalence of CKD and may support the hypothesis that the accumulation of unhealthy lifestyle behaviors leads to an increase in incidence of CVD and development of ESRD. Based on our results, we consider it necessary to perform lifestyle counseling, especially counseling that focuses on regular habitual exercise and healthy eating habits (such as avoiding late-night dinners and bedtime snacking), to reduce the incidence of CKD. Additional research in a larger sample is necessary to more precisely clarify the mechanisms, clinical implications, and associations between unhealthy lifestyle behaviors and the incidence of CKD following long-term intervention. In particular, the number of patients with ESRD in Japan is on the rise with the increase in prevalence of type 2 diabetes, so further studies are also needed to clarify the influence of unhealthy lifestyle behaviors on CKD in subjects with type 2 diabetes.

Conclusions

This study was designed to evaluate the association between unhealthy lifestyle behaviors and the prevalence of CKD in middle-aged and older men. We found that the OR for CKD significantly increased with an increase in the number of unhealthy lifestyle behaviors. Furthermore, after adjusting for age, BMI, smoking, drinking habits, triglyceride and HbA1c levels, and systolic and diastolic blood pressure, we found that a lack of habitual moderate exercise, late-night dinner, and bedtime snacking were significantly associated with the prevalence of CKD. These results suggest that an accumulation of unhealthy lifestyle behaviors, especially lack of habitual moderate exercise, late-night dinner, and bedtime snacking, may be associated with the prevalence of CKD.

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